Concussion: Temporary subs more important than misuse of rule, says PFA

Robin Koch receives medical attention for a head injury
Leeds defender Robin Koch was allowed to play for almost 20 minutes after suffering a head collision in Sunday’s defeat to Manchester United

Not bringing in temporary concussion substitutes over concerns that clubs could use it to their advantage would be wrong, says a senior official at the Professional Footballers’ Association.

Leeds said they were in favour of temporary replacements after defender Robin Koch suffered a head injury on Sunday against Manchester United.

Koch played on with his head bandaged before he was substituted.

On Monday the PFA said on Twitter that the present rules were ‘not working’.

The International Football Association Board (Ifab), football’s lawmakers, has just extended their concussion trials, which only allow for permanent substitutions, by another year.

While it says it is open to testing alternative protocols as well, at this stage it feels permanent substitutes is the most appropriate way forward but the PFA believes this is wrong.

“We have heard concerns that players and clubs may seek to use the temporary concussion sub to gain a competitive advantage – the opportunity to bring on a fresh player, give another player a break or break up the momentum of the match,” PFA assistant chief executive Simon Barker told BBC Sport.

“This order of priority is completely wrong. Player safety has to come first, above all else. You can’t be willing to risk putting players at risk of serious harm to offset potential and unlikely misuse of a rule.”

Barker has been part of the discussion process over the concussion issue with Ifab.

One of his concerns is that, in most parts of the world, they do not view it as a major issue, while even many of the most notable football countries lack the capability to run extensive studies around the impact of concussion on individuals that have received such prominence in the United Kingdom.

While the PFA understands the rationale behind using permanent substitutions, and player assessments being done on the pitch, and feels the ideal behind them is a good one, they believe, in practice, it doesn’t work. It thinks it would be better for a player to return to the relative quiet of an empty dressing room for checks to take place.

“Assessing a traumatic brain injury is always going to be difficult,” said Barker. “Symptoms can take up to 48 hours to develop, so even with temporary substitutions, it is still challenging.

“But under current rules, medical teams are expected to carry out complex assessments and make decisions based on limited information in a short timeframe.

“The stakes in elite football are incredibly high. Players will often try to continue playing, and with the adrenaline still running, their first instinct is to stay on the pitch.

“The assessment is taking place in front of a packed stadium of fans and potentially being broadcast to a global audience. Medics have to make a potentially game-altering decision in a very limited time, in a situation loaded with pressure.

“In our opinion, the rules need to be changed to give medical teams and players the time and space to make an assessment in an appropriate environment.”

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